Abstract

Background

Few studies have examined the effects of race and region on dietary intakes and the
evidence on racial and regional disparities among women is limited. We aimed to examine
whether race and region were associated with nutrient intakes among black and white
women living in the Stroke Belt, Stroke Buckle, and Other regions in the United States.
We hypothesized that significant differences would be observed among population sub-groups
and that the effects of race on dietary intakes would vary across regions.

Methods

This study included dietary data from 12,105 women from the Reasons for Geographic
and Racial Differences in Stroke study (United States). Dietary data were collected
using the Block 98 food frequency questionnaire.

Results

Blacks consumed 1.05% lower energy from saturated fat (95% CI: -0.95, -1.16), and
intakes were also lower in the Buckle (β = -0.20; 95% CI: -0.08, -0.32) and Belt (β
= -0.35; 95% CI: -0.24, -0.46) compared to the Other regions. Within each region,
sodium, potassium, and magnesium intakes were all lower among black women compared
to white women (P <0.05 for all); intakes were significantly lower among blacks living in the Belt and
Buckle compared to those in the Other regions. Significant interactions between race
and region were detected for trans fat, calcium, and cholesterol (P <0.05 for all), where black women in the Other regions consumed the lowest dietary
cholesterol and calcium while black women in the Belt consumed the lowest trans fat.

Conclusions

Race and region were significantly associated with nutrient intakes in a large study
of black and non-Hispanic white women in the United States. Intakes of trans fat,
calcium, and cholesterol among black and white women differed across regions. Race
and region thus interact to impact dietary intakes, and their effects may be mediated
by such factors as the broader food environment and food availability as well as food
customs and culture. Race, region, and their correlates should therefore be considered
together when examining diet and disease associations and planning dietary advice
for population sub-groups.